Shaping, Disinfection, and Obturation for Molars

Shaping the canal system to promote disinfection and obturation is the cornerstone of molar endodontics. Clinical outcomes, both long and short term, hinge on the technical quality and attention to detail invested into this step. This chapter summarizes currently understood best practices, independent from specific instruments or technologies. A historically proved lead principle here, as in medicine in general, is “do not harm.”

[1]  J. Vera,et al.  Dynamic movement of intracanal gas bubbles during cleaning and shaping procedures: the effect of maintaining apical patency on their presence in the middle and cervical thirds of human root canals-an in vivo study. , 2012, Journal of endodontics.

[2]  G. Cantatore,et al.  The influence of a manual glide path on the separation rate of NiTi rotary instruments. , 2005, Journal of endodontics.

[3]  A. Çetin,et al.  The effect of different restoration techniques on the fracture resistance of endodontically-treated molars. , 2008, Operative dentistry.

[4]  H. Messer,et al.  The quality of apical canal preparation using hand and rotary instruments with specific criteria for enlargement based on initial apical file size. , 2002, Journal of endodontics.

[5]  A. Izu,et al.  Effectiveness of sodium hypochlorite in preventing inoculation of periapical tissues with contaminated patency files. , 2004, Journal of endodontics.

[6]  R. Walton,et al.  Determining the optimal obturation length: a meta-analysis of literature. , 2005, Journal of endodontics.

[7]  K. Gulabivala,et al.  A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. , 2011, International endodontic journal.

[8]  E. Rosenfeld,et al.  Vital pulp tissue response to sodium hypochlorite. , 1978, Journal of endodontics.

[9]  Gary S P Cheung,et al.  A retrospective study of endodontic treatment outcome between nickel-titanium rotary and stainless steel hand filing techniques. , 2009, Journal of endodontics.

[10]  M. Haapasalo,et al.  Eradication of endodontic infection by instrumentation and irrigation solutions , 2005 .

[11]  F. Paqué,et al.  Determining cutting efficiency of nickel-titanium coronal flaring instruments used in lateral action. , 2014, International endodontic journal.

[12]  Jean-Paul Micallef,et al.  Location of contact areas on rotary Profile1 instruments in relationship to the forces developed during mechanical preparation on extracted teeth , 1999 .

[13]  C. Chehoud,et al.  Prevalence of Apical Periodontitis in Endodontically Treated Premolars and Molars with Untreated Canal: A Cone-beam Computed Tomography Study. , 2016, Journal of endodontics.

[14]  R E Walton,et al.  Apical terminus location of root canal treatment procedures. , 2000, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[15]  D. Ørstavik,et al.  Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing. , 2005, Journal of endodontics.

[16]  F. Tay,et al.  Review of contemporary irrigant agitation techniques and devices. , 2009, Journal of endodontics.

[17]  J. Vera,et al.  Effect of maintaining apical patency on irrigant penetration into the apical two millimeters of large root canals: an in vivo study. , 2012, Journal of endodontics.

[18]  O. Peters,et al.  Physicochemical and pulp tissue dissolution properties of some household bleach brands compared with a dental sodium hypochlorite solution. , 2012, Journal of endodontics.

[19]  M. Zehnder.  Root canal irrigants. , 2006, Journal of endodontics.

[20]  D. Ørstavik,et al.  Disinfection by endodontic irrigants and dressings of experimentally infected dentinal tubules. , 1990, Endodontics & dental traumatology.

[21]  C. Ruddle.  Shaping for success...everything old is new again. , 2006, Dentistry today.

[22]  A. Wennber,et al.  Adhesion of root canal sealers to bovine dentine and gutta-percha. , 1990 .

[23]  G Sundqvist,et al.  Factors affecting the long-term results of endodontic treatment. , 1990, Journal of endodontics.

[24]  O. Peters,et al.  Impact of lubricant parameters on rotary instrument torque and force. , 2007, Journal of endodontics.

[25]  O. Peters,et al.  Effect of root canal treatment procedures with a novel rotary nickel titanium instrument (TRUShape) on stress in mandibular molars: a comparative finite element analysis , 2016, Odontology.

[26]  S. Friedman.  Management of post-treatment endodontic disease: a current concept of case selection. , 2000, Australian endodontic journal : the journal of the Australian Society of Endodontology Inc.

[27]  K Langeland,et al.  Apical limit of root canal instrumentation and obturation, part 2. A histological study. , 2002, International endodontic journal.

[28]  V. Himel,et al.  Evaluation of pigmented intraorifice barriers in endodontically treated teeth. , 1999, Journal of endodontics.

[29]  O. Peters,et al.  Disinfection of root canals with photon-initiated photoacoustic streaming. , 2011, Journal of endodontics.

[30]  C. Boutsioukis,et al.  Fluid dynamics of syringe-based irrigation to optimise anti-biofilm efficacy in root-canal disinfection , 2012 .

[31]  J. West,et al.  Endodontic update 2006. , 2006, Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.].

[32]  F. Paqué,et al.  Tubular sclerosis rather than the smear layer impedes dye penetration into the dentine of endodontically instrumented root canals. , 2006, International endodontic journal.

[33]  I. N. Rôças,et al.  Apically Extruded Sealers: Fate and Influence on Treatment Outcome. , 2016, Journal of endodontics.

[34]  G. Mattison,et al.  The survivability of F43 strain of Streptococcus sanguis in root canals filled with gutta-percha and Procosol cement. , 1983, Journal of endodontics.

[35]  M. Abou-Rass,et al.  The effectiveness of four clinical irrigation methods on the removal of root canal debris. , 1982, Oral surgery, oral medicine, and oral pathology.

[36]  F. Paqué,et al.  Root canal preparation of maxillary molars with the self-adjusting file: a micro-computed tomography study. , 2011, Journal of endodontics.

[37]  J. Vera,et al.  Effect of maintaining apical patency on irrigant penetration into the apical third of root canals when using passive ultrasonic irrigation: an in vivo study. , 2011, Journal of endodontics.

[38]  M. Cayón,et al.  Apical transportation created using three different patency instruments. , 2010, International endodontic journal.

[39]  J F Siqueira,et al.  Aetiology of root canal treatment failure: why well-treated teeth can fail. , 2001, International endodontic journal.

[40]  T. Attin,et al.  Preparation of oval-shaped root canals in mandibular molars using nickel-titanium rotary instruments: a micro-computed tomography study. , 2010, Journal of endodontics.

[41]  Roland Weiger,et al.  The ability of root ZX apex locator to reduce the frequency of overestimated radiographic working length. , 2002, Journal of endodontics.

[42]  J. Burleson,et al.  A prospective cohort study of endodontic treatments of 1,369 root canals: results after 5 years. , 2011, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[43]  K. Gulabivala,et al.  A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health. , 2011, International endodontic journal.

[44]  T. Mullaney,et al.  Prevalence of teaching apical patency and various instrumentation and obturation techniques in United States dental schools. , 1997, Journal of endodontics.

[45]  J. Baumgartner,et al.  A scanning electron microscopic evaluation of four root canal irrigation regimens. , 1987, Journal of endodontics.

[46]  Ove A Peters,et al.  Current challenges and concepts in the preparation of root canal systems: a review. , 2004, Journal of endodontics.

[47]  J. W. Harrison,et al.  Chemomechanical removal of pulpal and dentinal debris with sodium hypochlorite and hydrogen peroxide vs normal saline solution. , 1977, Journal of endodontics.

[48]  R. Sodhi,et al.  Interaction between sodium hypochlorite and chlorhexidine gluconate. , 2007, Journal of endodontics.

[49]  A. Reader,et al.  In vivo debridement efficacy of ultrasonic irrigation following hand-rotary instrumentation in human mandibular molars. , 2005, Journal of endodontics.

[50]  P. Jonasson,et al.  Long-term survival of endodontically treated teeth at a public dental specialist clinic. , 2015, Journal of endodontics.

[51]  Ya Shen,et al.  Tissue dissolution by a novel multisonic ultracleaning system and sodium hypochlorite. , 2014, Journal of endodontics.

[52]  O. Peters,et al.  Effect of liquid and paste-type lubricants on torque values during simulated rotary root canal instrumentation. , 2005, International endodontic journal.

[53]  Peter M. Di Fiore.  A dozen ways to prevent nickel-titanium rotary instrument fracture , 2007 .

[54]  A. Arias,et al.  Relationship between postendodontic pain, tooth diagnostic factors, and apical patency. , 2009, Journal of endodontics.

[55]  C Boutsioukis,et al.  Irrigant flow within a prepared root canal using various flow rates: a Computational Fluid Dynamics study. , 2009, International endodontic journal.

[56]  R. Walton,et al.  Bacterial penetration through canals of endodontically treated teeth in the presence or absence of the smear layer. , 2003, Journal of dentistry.

[57]  D. H. Flanders.  Endodontic patency. How to get it. How to keep it. Why it is so important. , 2002, The New York state dental journal.

[58]  Mark Olsen,et al.  Ability of new obturation materials to improve the seal of the root canal system: a review. , 2014, Acta biomaterialia.

[59]  B. Basrani,et al.  Update on endodontic irrigating solutions , 2012 .

[60]  M. Pettiette,et al.  Evaluation of success rate of endodontic treatment performed by students with stainless-steel K-files and nickel-titanium hand files. , 2001, Journal of endodontics.

[61]  M. Hülsmann,et al.  Chelating agents in root canal treatment: mode of action and indications for their use. , 2003, International endodontic journal.

[62]  R. A. Souza.  The importance of apical patency and cleaning of the apical foramen on root canal preparation. , 2006, Brazilian dental journal.

[63]  M. Yamauchi,et al.  Effect of orifice plugs on periapical inflammation in dogs. , 2006, Journal of endodontics.

[64]  P. Nair.  On the causes of persistent apical periodontitis: a review. , 2006, International endodontic journal.

[65]  J. Leeb.  Canal orifice enlargement as related to biomechanical preparation. , 1983, Journal of endodontics.

[66]  P M H Dummer,et al.  Consequences of and strategies to deal with residual post-treatment root canal infection. , 2006, International endodontic journal.

[67]  B. Sener,et al.  Interactions of ethylenediamine tetraacetic acid with sodium hypochlorite in aqueous solutions. , 2003, International endodontic journal.

[68]  Buchanan Ls.  Management of the curved root canal. , 1989 .

[69]  Mahmoud Torabinejad,et al.  Clinical implications of the smear layer in endodontics: a review. , 2002, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[70]  M Torabinejad,et al.  Effect of preflaring on tactile detection of the apical constriction. , 1995, Journal of endodontics.

[71]  O. Peters,et al.  Effectiveness of the erbium:YAG laser and new design radial and stripped tips in removing the smear layer after root canal instrumentation , 2012, Lasers in Medical Science.

[72]  M. Torabinejad,et al.  Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis. , 2010, Journal of endodontics.

[73]  H. Tezel,et al.  The penetration of root canal sealers into dentinal tubules. A scanning electron microscopic study. , 1993, International endodontic journal.

[74]  J. Siqueira,et al.  Fate of the tissue in lateral canals and apical ramifications in response to pathologic conditions and treatment procedures. , 2010, Journal of endodontics.

[75]  S. Dorn,et al.  The impact of post space preparation with Gates-Glidden drills on residual dentin thickness in distal roots of mandibular molars. , 2004, Journal of the American Dental Association.

[76]  Franklin R Tay,et al.  Anatomy of sodium hypochlorite accidents involving facial ecchymosis - a review. , 2013, Journal of dentistry.